Waiver

Express
assumption of risk: I, the undersigned, am
aware that there are significant risks involved in all aspects of physical
training. These risks include, but are not limited to: falls which can result
in serious injury or death, injury or death due to negligence on the part of myself,
my training partner, or other people around me, injury or death due to improper
use or failure of equipment. I am aware that any of these above mentioned risks
may result in serious injury or death to myself and or my partner(s). I
willingly assume full responsibility for the risks that I am exposing myself to
and accept full responsibility for any injury or death that may result from
participation in any activity or class while at Crossfit GerryMich LLC. I, the undersigned acknowledge that I
have no physical impairments or illnesses that will endanger myself or others

Release: In consideration of the above mentioned risks
and hazards and in consideration of the fact that I am willingly and
voluntarily participating in the activities available at Crossfit GerryMich
LLC, I, the undersigned hereby release Crossfit GerryMich LLC, their
principals, agents, employees, and volunteers from any and all liability,
claims, demands, actions or rights of action, which are related to, arise out
of, or are in any way connected with my participation in this activity,
including those allegedly attributed to the negligent acts or omissions of
Crossfit GerryMich LLC, their principals, agents, employees, and volunteers.
This agreement shall be binding upon me, my successors, representatives, heirs,
executors, assigns, and/or transferees. If any portion of this agreement is
held invalid, I agree that the remainder of the agreement shall remain in full
legal force and effect. I also give full permission for any person connected
with Crossfit GerryMich LLC to administer first aid deemed necessary, and in
case of serious illness or injury and call emergency services seen necessary. I
also release the right for Crossfit GerryMich LLC to use any media (photos or
video) taken of me to promote CrossFit BrickYard.

Indemnification: The participant recognizes that there is risk
involved in the types of activities offered by Crossfit GerryMich LLC.
Therefore the participant accepts financial responsibility for any injury that
the participant may cause either to him/herself or to any other participant due
to his/her negligence. Should the above mentioned parties, or anyone acting on
their behalf, be required to incur attorney’s fees and costs to enforce this
agreement, I agree to reimburse them for such fees and costs. I further agree
to indemnify and hold harmless Crossfit GerryMich LLC, their principals,
agents, employees, and volunteers from liability for the injury or death of any
person(s) and damage to property that may result from my negligent or
intentional act or omission while participating in activities offered by
Crossfit GerryMich LLC.

I have read
and understood the foregoing assumption of risk, and release of liability and I
understand that by signing it obligates me to indemnify the parties named for
any liability for injury or death of any person and damage to property caused
by my negligent or intentional act or omission. I understand that by signing
this form I am waiving valuable legal rights.

* Please use your mouse/finger to sign your name

* By clicking this checkbox you agree to online signature signing of this waiver